The overall goal of this project is to close existing gaps between identification of hearing loss in young infants and the provision of appropriate interventions. Historically, there have been delays between identification of hearing loss in infants and referral for intervention, which have undermined the benefits of early detection and subsequent intervention. Nationwide implementation of newborn hearing screening programs will substantially lower the average age of identification. This creates a critical need to communicate with medical professionals, early interventionists and parents about newborn screening and follow up issues in order to optimize the benefits of early detection. The first aim of this project is to increase the knowledge and change attitudes of healthcare providers regarding newborn hearing screening and the need for referral. Following the identification of needs and behavioral change objectives, health communication programs will be developed and disseminated through a multimedia website, a multimedia program for use in Grand Rounds, and fact sheets and brochures designed for the newborn nursery. The results should increase knowledge of the medical community and positively influence attitudes about the importance of referral and intervention for infants with any degree of hearing loss. The second aim is to increase technical skills of clinicians in implementing developmentally appropriate and relationship-focused interventions through a clinical mentoring program and website development. The results should increase understanding of effective early intervention practices and improve the strategies for involving families in intervention. Enhanced involvement of families should result in increased self-efficacy on the part of parents of children who are deaf and hard-of-hearing. The final aim is to increase parents' understanding and self-efficacy related to complex issues that surround audiological and genetic diagnosis and amplification options for infants. Families will be provided access to state-of-the-art information through videotapes, a multimedia website, and brochures. A media advocacy program will also be implemented. The results should promote parental self-advocacy and independence in decision making.